Call responsibilities

[KMATTOX at aol.com]

This is in response to a post cited below regarding emergency surgery call,  
etc.  
 
I have recently had an opportunity to discuss this issue locally, and  among  
many on this list server nationally.   Some desired to  remain nameless.    I 
came up with the following  information:   
 
1.    Many MANY surgical disciplines are positioning  themselves to perform 
only endoscopic or endovascular  procedures.    MANY also are positioning 
themselves to NEVER be  in a position to be put on any IN-hospital surgical call, 
and almost never have  to respond to coming to the hospital at night, week ends 
or on holidays.  
 
2.    Many new and training surgeons are very  uncomfortable with an OPEN 
ABDOMEN or a major trauma case.   
 
3.    For MANY reasons, the surgeon, the general  surgeon, the emergency 
surgeon, the acute care surgeon, the trauma surgeon  (choose whatever name you 
wish) is CURRENTLY and FOR THE NEXT 15 years will be  the most sought after 
specialist in most hospitals in the country; and the  rarest commodity.     AND as 
a base of the triangle of  hospital practice, this surgeon is the most 
valuable to the hospital  enterprise.   DO NOT UNDERSELL YOURSELF or be put into a 
position  where you feel that your value is under rated, 
 
4.    JUST to be in the hospital taking call and seeing  patients you should 
expect $100.00/hour to be paid to you by the  hospital.   This payment is a 
minimum for your TIME.  
 
5.    You should expect to receive payment for your  SERVICES.    That should 
be paid at (at least) a rate of 150% or  higher of allowable Medicare rates 
after ALL discounts, etc.   This  amount should almost be a guarentee be it 
from a carrier, the patient, insurance  companies, HMOs, or the hospital.   
 
6.    If the hospital is seeing non-pay patients as  part of its community 
commitment and expects you to be there, the hospital  should pay you this 
conversion factor for your services if the patient does not  have a the resources or 
insurance.   
 
7.    You should expect to keep all of what you collect  without having to 
share with the hospital.  You may have a group or medical  school plan that has 
some other arrangement.  
 
8.    More later
 
K 
 
In a message dated 12/4/2007 1:47:24 P.M. Central Standard Time,  
pjschu at bpthosp.org writes:

Folks,
I'm trying to benchmark expectations for nights on call for  the members
of my group based on practices around the country. We're a  small group
that does

1) All SICU staffing and call
2) 75% of  Trauma call (Level II)
3) All critical burn care (ABA verified. 310  admissions per year)
4) 80% of burn operative care
5) about 50% of  emergency general surgery in the hospital.







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